This past year we have focused our ultrasound (US) and videofluoro-scopic (VF) studies of swallowing on a new group of patients with progressive supranuclear palsy (PSP) and have begun to follow some of the original patients with cystinosis whom we studied in 1989'1991. We are currently examining the affects of denepezil on oral motor and swallowing function in patients with PSP. Patients do not receive treatment but are reevaluated using US and VF before, during, and after drug administration. We have seen 14 patients and are halfway through the study.We are also using the computerized swallowing programs we developed last year to conduct a frame-by-frame analysis of timing and displacement of the hyoid bone. We have completed a study using simultaneous EMG and VF to aid our understanding of the ability of the deglutitive motor system to accommodate the changing demands of differing swallowing patterns. The concept of a delay in the pharyngeal swallow has been considered as a primary diagnostic sign of dysphagia on the VF examination. We are studying this finding, and it appears that the pattern may be part of the normal swallow.